Adrenocortical function in type II hyperlipoproteinemic patients treated with lovastatin (mevinolin)

Lovastatin (Mevinolin), a competitive inhibitor of the enzyme 3-hydroxy-3-methylglutaryl-coenzyme A reductase, has been used effectively as a hypocholesterolemic agent in man. As an inhibitor of endogenous cholesterol synthesis, a potentially serious side effect of therapy with this drug is interference with adrenocortical function. The effect of lovastatin on adrenal function was evaluated in a 6-month, randomized, double blinded, placebo-controlled, crossover study involving 24 type II hyperlipoproteinemic patients. Despite significant lowering of total and low density lipoprotein (LDL) cholesterol by lovastatin, no statistically or clinically significant differences were seen in free cortisol excretion or in plasma cortisol response to intravenous ACTH infusion between baseline, placebo, and lovastatin-treated patients. We conclude that lovastatin does not adversely affect adrenocortical reserve in patients with heterozygous familial hypercholesterolemia (FH) or non-FH type II hyperlipoproteinemia.